Organization
BROAD AVENUE PHARMACY LLC
Active
Other names
Broad Avenue Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PHAT QUACH (PHARMACY MANAGER)
(504) 309-4388
Entity
Organization
Contact information
Practice address
1400 N BROAD ST, NEW ORLEANS, LA 70119-2332
(504) 309-4388
(504) 309-4389
Mailing address
1400 N BROAD ST, NEW ORLEANS, LA 70119-2332
(504) 309-4388
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
10/23/2018
Last updated
05/12/2020
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